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Anxieties of Childbirth

In our book A Womb of Her Own, (Routledge, 2017) author Helena Vissing writes as follows:

Balsam is in line with Holmes (2008) on the potential for psychic restructuring in childbirth: “It seems that the experience of childbirth may be so potent that the regression mobilized in the service of the ego may even make room for internalization of an alternative mothering experience for a birthing woman.” (2012, p. 91). During pregnancy, the mother experiences a bifurcated identification with both her own mother and the fetus (Bibring, 1959). Childbirth marks the abrupt termination of this symbiotic identification. The identifications and the regressive pressure they exert on the woman are often frightening (Holmes, 2008), even though they are often also accompanied by longings. Primitive longings for symbiosis coupled with the fear of the engulfing pre-oedipal mother can produce the intense ambivalence that Parker (1995) described as an inevitable and important part of maternal development. Furthermore, childbirth marks the point of the expulsion of the self-object that the fetus represents, which has carried important projections throughout the pregnancy (Holmes, 2008). The termination of the symbiosis is therefore potentially both threatening and rewarding. Holmes notes that the symbiosis in pregnancy reflects a paradox: “It requires identification with mother for the unconscious to permit pregnancy, but by identifying with mother enough to get pregnant, a woman can finally, in childbirth, achieve true individuation and psychic separation from mother” (2008, p. 31).

The Sexual and Orgasmic Aspects of Childbirth

We see acknowledgments of the sexual and orgasmic aspects of childbirth throughout the psychoanalytic literature on motherhood. Balsam (2012) describes the intimate relationship between the development of the little girl’s body pleasures and her mother’s private sexuality, linking the maternal object and a woman’s sexuality from an embodied perspective. The fetal movements are understood as evoking pleasure, and the milk coming in is a central sexual event. The baby is a “natural sex object” for the mother. What is radically different in feminist-embodiment psychoanalysis from the philosophy of Orgasmic Birth, is the focus on the pain and hatred as equally important in the motherhood transition and in childbirth as the pleasure. For example, birth can be seen as a loss of the sexual pleasure of the fetal movement. This understanding is seen in Holmes’ thesis (2008), where childbirth is a massive loss in the sense of the very concrete way the delivery of the baby parallels the psychological detachment from a self-object that is saturated with projections. The pain and loss of childbirth are just as important as the sexual pleasure, and the tension and ambivalence that follows are central. The plasticity and fluidity of the female body, however natural and developmentally important, also cause for anxieties around childbirth. Balsam (2012) confirms that flux is normative for a woman’s physicality, stating that “females mentally register a rhythm of dimensional corporeal oscillation” (p. 84). She also contends that many likely experience these shifts with anxiety.

Boundary Issues in Childbirth

This brings up an issue in female and maternal development that I call the boundary problem. Reproduction exerts tremendous pressure on all thinkable boundaries for a woman: physically, mentally, emotionally, spiritually, and socially, and there is no way out of this pressure in the maternal transformation (Vissing, 2015). Because it is largely driven by body processes, the unique pressure of motherhood will be reacted to from the body rather than mentally. A woman who wishes to have a baby will, therefore, be confronted with the problem of how to maintain and assert her boundaries so she is not taken over by the transition, while still accepting the boundary instability and fluidity as necessary and gratifying. The fluidity of boundaries embedded in female life holds powerful creative and destructive forces; they accumulate with intensity throughout pregnancy and culminate in childbirth. Balsam (2012) suggests a plausible dynamic of female anxieties about childbirth: “The basal state of the constant flux of the mature female body is peaked by pregnancy and childbirth. Could it be that hidden anxieties about this major personal confrontation with this body flux, accompanied as it is by serious matters of life and death, is a kind of black hole that lurks in many, many female psyches?” (p. 85).

Anxieties of Childbirth

With this feminist-embodiment psychoanalytic understanding, we can appreciate the anxieties of childbirth without understanding them as symptoms of cultural and obstetric oppression. Rather, they are embedded in the female unconscious as primitive reactions to the inescapable corporeality of female life. Zeavin (2011) has aptly described the destructive and horrifying aspects of birth: “No matter how thrilling the birth of a baby […] it is always in a sense traumatic. Giving birth inevitably evokes our most primitive fears and fantasies: many women describe the fear of coming undone, of violence to the inside of their bodies, a fear of being unseemly and even grotesque” (2011, p. 63).


Balsam, R.H. (2012). Women’s bodies in psychoanalysis. New York, NY US: Routledge/Taylor & Francis Group
Holmes, L. (2008). The internal triangle. New theories of female development. New York: Jason Aronson.
Parker, R. (1995). Mother love/Mother hate. New York: BasicBooks.
Vissing, H. (2014). The ideal mother fantasy and its protective function. In L. Ennis (Ed.),
Zeavin, L. (2011). ‘What about the episiotomy? A response to Katie Gentile’s article “What about the baby?”’. Studies in Gender and Sexuality, 12, 59 – 64.

Anxieties of Childbirth

Ellen Toronto, Ph.D.

Dr. Ellen Toronto is a licensed clinical psychologist/psychoanalyst in the state of Michigan.

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APA Reference
Toronto, E. (2019). Anxieties of Childbirth. Psych Central. Retrieved on November 29, 2020, from


Last updated: 19 Apr 2019
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